Fixing Hell (26 page)

Thankfully, Janet gently placed her right hand on my left arm and whispered softly, “Larry, it’s gonna be okay. Now, just settle down. I’ll clean this mess up. Why don’t you go in the bedroom and relax? I’ll take care of this.” She picked up little Judy and hugged her. As I walked away, I turned and looked at my wife. Her eyes told me that she wondered if her once calm, gentle, fun-loving husband would ever be the same. For the first time, it was not only clear to me, but to Janet as well, that I was not well and not that same man who left for Abu Ghraib. As usual, the gentle touch of my wife served as my elixir. I calmed down. Janet kept Judy quiet and away from me for a couple of hours. Later in the day, Janet asked, “What was that all about this morning?” I shrugged my shoulders, walked away to the upstairs bathroom, locked the door, and cried my eyes out, thinking about the terrified, hurt look on that innocent child’s face as I was screaming at her like a madman. I got down on my knees and asked God to help me. I begged for his forgiveness. Part of the problem was that I didn’t know the full answer as to why I had unleashed such anger and rage at my three-year-old granddaughter the way I did. She was a child and didn’t deserve it. Or perhaps I was now able to see that I had become emotionally impaired like so many other veterans. I had heard of veterans tearing their houses apart in an unstoppable rage after returning from Iraq, but even as a psychologist I never really understood what prompted such outbursts. Was I just like them?

No! I said to myself, I’m better and stronger than them, and plus, I’m a psychologist. This PTSD stuff can’t happen to me.
I gathered myself, went downstairs, and hugged my granddaughter and told her I was sorry. Almost within an instant she smiled and asked me if we were going to go to the beach. Children are so wonderfully forgiving.

Over time, either in person or by phone I would have several conversations with an old friend and senior psychologist from Walter Reed, Dr. Hal Wain. Talking with Hal was always enlightening but it was also healing for me. He helped me work through many of these issues and he never made me feel as though I were mentally ill. He framed what I was going through as a perfectly normal response to abnormal events. I shared my experience at the Starbucks in Kuwait with Dr. Wain. Hal, in his usual brilliant way, helped me to realize that it was the classic psyche struggle.

“Larry, your psyche has figured out a way to reframe the nightmares for you in a healthy way,” he said. “Don’t run from this, Larry. Embrace it.”

He was right. Slowly, over time, I began to return to normal, or so I thought. I busied myself again with teaching, getting back to doing research, and seeing patients. The symptoms of our nation’s new PTSD was in many cases, like mine, very subtle and unlike the old Vietnam veteran stereotypes. Many of us did not disappear from society or turn to alcohol or drugs like the PTSD vet of earlier eras. Janet was the first to see the subtleties of my condition. One evening I was walking downstairs at our home with a cup of coffee in my right hand. Our downstairs is flat with level carpet. Suddenly the coffee cup fell from my hand. A few days later, a bowl of cereal just fell out of my hands. This became common and would occur at least once or twice a week. Whatever I had in my hands would just fall to the floor.

While I was struggling with the lack of muscle coordination in my hands, I started to have trouble with tripping while walking on a level, flat surface without any obstructions. I would be walking down the hallway at my department and I would stumble or trip. The problem would also occur at home. One day Janet and I were loading up in our car, and I went back in the house to get a cup of coffee. While walking across the living room, I stumbled and the coffee cup hit the wall and carpet. Janet came to my rescue, never complaining or patronizing. Again her patience had a curative effect on me.

We loaded in the car and needed to stop by my office on our way to downtown Honolulu for a meeting. By the time we arrived at my office it was after hours and I had left my keys and wallet at home. This was a significant event for Janet. Even though I tried to downplay it, she knew it was a sign of something terribly wrong with her husband. In our thirty years together, I had neither misplaced my keys nor ever lost my wallet. That just wasn’t something I ever did. She said, “No problem, sugar, we can just go back home and get your keys.” Forty-five minutes later we arrived back at our home, but for a long while I couldn’t find my keys or my wallet. On the drive back downtown, Janet spoke up.

“Sugar, I’m really worried about you. You can’t find your keys, your wallet, and you’re stumbling and falling all the time. Larry, what’s going on? You’re yelling and screaming at Judy in a way like I’ve never seen you yell at anybody. I think you ought to go and see our doctor.” Her voice trembled with worry and fear for me as she continued. “You look like shit and you can’t walk around the block once without taking a nap. You used to be able to run four miles a day, do 150 push-ups and 300 crunches without taking a break. Now you’re fatigued all the time. You need to see our doctor because I’m really worried about you.”

I promised her that when I went in to work on Monday I would schedule an appointment with our physician. I never did.

I think I meant to follow through with what I promised Janet, but my worsening symptoms only made me more fearful of admitting to someone else that I had a problem. I got up early on Monday morning as usual for my four-mile run, but I couldn’t finish the run. I was so fatigued after fifteen minutes of running that I had to just stop and walk. Somehow I never found time to go and see my physician. I thought I’d just tighten up my bootstraps and soldier through it, whatever it was. The level of fatigue I was experiencing was like carrying an extra fifty-pound backpack around all day long. I didn’t care. I just drove on.
Larry, there’re soldiers coming back from Iraq with one leg who run marathons, I told myself. Don’t be a pussy, Larry. Just soldier through this. Hang on. It will get better.

Either my staff at Tripler Army Medical Center was very patient with me or I was damn good at bluffing my way right through my mental confusion and cognitive lapses. I had worked with many of my staff members for years, but for some strange reason I would lose their names right in the middle of conversations. It was like my mental hard disk drive was crashing. Sometimes it would work and other times it didn’t. Novel information from patients I had very little difficulty handling. But trying to recall old information was troubling, as when I was having a conversation with Dr. Jim Kamona, who had been a psychologist at Tripler for years. Jim came in my office one morning to seek my advice about a research project. Right in the middle of our conversation, I couldn’t recall his name nor could I figure out what in the hell we were talking about. Within an instant, my brain was engulfed in a mental fog. It was as though he had called me at 3 a.m. and asked me to say my Social Security number backwards. I didn’t panic; I just smiled a lot, nodded my head often, and after about fifteen minutes or so, it all came back to me. That became my strategy when I found myself lost in the wilderness like that, and I think most of the time the other person didn’t catch on. They didn’t know, but I was terrified! I thought I was losing my mind.

Janet saw this more and more at home, first by me losing my wallet and keys ten times the first week I was back home. She would just remain calm, never showing her frustration, and wait until the fog lifted. I was horrified by the episodes and scared, for the first time in many years, that the once articulate senior Army psychologist would be lost forever.

Then a weekend would go by without me dropping anything or losing my memory. My symptoms would come and go. The more I thought about it, the more I realized that this was consistent with early-onset Alzheimer’s disease. I was perplexed by all of this. I was not myself at all. But what seemed strange was that I didn’t fit the typical PTSD Vietnam veteran stereotype. I wasn’t having nightmares anymore, I didn’t drink much alcohol at all, and I wasn’t beating my wife. Yet I was clearly feeling the effects of the war. I just wasn’t right, as my wife said more than once.

One Monday morning I turned the TV in my office to CNN. Amazingly, an old colleague of mine from Walter Reed Army Medical Center was doing an interview. Dr. Deb Warden, a noted neurologist and psychiatrist, was talking about how researchers had discovered that some soldiers who had been exposed to blast injuries or extreme stress had abnormal brain scans. Dr. Warden lifted the whole world off my shoulders by explaining my symptoms to me through her CNN interview. I sat there dumbfounded but increasingly relieved as she described every symptom that plagued me: mental confusion, memory loss, rage episodes, and spontaneous stumbling while walking were now commonly seen in some veterans returning from the war. We also now know that the symptoms of soldiers who lose consciousness during a blast explosion get worse, and some never return to who they were before the war. I was lucky—I never lost consciousness. But still, I was one of those veterans who was struggling. I couldn’t hide it anymore.

I went home that night and had a long talk with Janet. She and I were relieved now, glad that at least we knew what was wrong. Dr. Warden’s interview vividly illustrated what happened to a soldier’s brain when he was blown off his feet by a bomb blast—as happened to me several times in Iraq. Dr. Warden explained that the tricky thing is that, like me, even though the soldier doesn’t crack his skull or get shot, the force from the blast still damages the brain. Put this together with the stress placed on the central nervous system from constant psychological strain of being in a combat zone, sleep deprivation, food deprivation, and the 120-degree heat, and the result can be an adverse impact on a soldier’s brain functioning and central nervous system—the new PTSD.

What was happening was that these soldiers were slipping through the cracks of the medical system, just like I did. Why? Well, soldiers like myself were never shot, never hit our heads, nor had any shrapnel from a roadside IED in us. We had two eyes, two ears, a nose, walked okay, and didn’t report any nightmares. The medical system had no reason to pay attention to us. We seemed normal when we returned home and didn’t request any assistance. The only saving grace was that, even when we didn’t seek help, for most of us the prognosis was good. Dr. Warden went on to say that most of these soldiers would return to their predeployment condition. Others—no one knew why—would never be the same.

My struggles grew less as time went on. Just when I thought I had it bad, a new patient, a new soldier walked into my world. I was in my office one day, as usual sipping on a cup of hot coffee and working on an article. My phone rang. It was my secretary. She said, “Colonel, I need your help up front, sir. There is a guy up here who needs some help.” She sounded a little odd. I said yes, that’d I’d come up front, but I didn’t understand why she was calling me with this. “Shouldn’t you be sending him to the psychiatry outpatient clinic or the emergency room?”

“Well sir, yes, I should but this soldier insists on only talking to somebody who is a combat veteran. Sir, most of our providers are civilians.”

I told her I would be right there.

Sergeant Jose Gomez was one horse of a soldier. This twenty-four-year-old specifically requested to see a psychologist who had been deployed to Iraq. Sergeant Gomez was a hard-charging, dedicated career medic. He loved being a soldier. He had a handsome Latin tan that seemed to accentuate his coal black hair and deep brown eyes. From his frame one could clearly see that this soldier dedicated at least two hours per day to the gym, with a purpose.

“What brings you in to see me, soldier?” I asked.

He responded with two words. Two words that symbolized the life, spirit, mind, and body of many soldiers upon their return home. He said, “I’m broken.”

“Son, I’m not sure I completely understand all of what you mean. What’s broken on you?” I asked.

“Sir, it’s not on me,” he said, obviously struggling to explain something that he didn’t fully understand himself. “It’s in me, Colonel. My heart . . . something . . . Sir, my mind, sir . . . My mind ain’t right, Colonel.”

Sergeant Gomez and I spent three hours together that day. He told me about how he had witnessed the carnage in Sadr City, Iraq, the worst ghetto and most dangerous place in that country. He was assigned to an armored cavalry unit. As a medic he was required to go wherever his unit went. The fighting was intense and almost daily for his unit. He saw old men, children, and his buddies get blown apart. And as a medic, he never had the option of turning away and trying to put it out of his mind. His job was to go into the worst of the carnage and try to help.

“Sir, I had to just put all my emotions in a box and not deal with this shit until I got back home,” he explained. “Colonel, I can’t sleep. I hear my dead buddies’ voices all the time. I have to drink three beers just to get to sleep at night, sir. I’m scared.”

Gomez had the more common PTSD-type symptoms. But what brought him in to see me right now?

“Sir, I threatened to choke my wife if she didn’t stop talking. Man, I was out of it this morning, Colonel. I never, ever thought about hitting my wife before.” As he told me this, Sergeant Gomez wept like a child whose mother had just died. I got his family physician to prescribe him medication for sleep and I would work with him in therapy twice a week for the next month and then each week for about six months. Sergeant Gomez got better, stayed with his wife, and rotated on to his next Army duty assignment. There were thousands of soldiers just like him.

My experience with Sergeant Gomez made me think back to a good friend, Colonel Charles Hoge, who had taken a team of researchers from Walter Reed to Iraq to conduct intensive study on the extent of mental health problems among our soldiers deployed to Iraq. I realized that Colonel Hoge and his colleagues had predicted exactly the symptoms that troubled Sergeant Gomez. The colonel and I shared a tent at Camp Victory every Saturday in August and September 2004. Charles and I would doze off to sleep at night while debating. I thought that his numbers overstated the levels of PTSD, depression, and anxiety among the troops. He, in his usually eloquent way, would disagree and say that they most likely underreported the seriousness of the problem. I had to agree now that Sergeant Gomez was neither rare nor unusual. We now know that at least 3 to 15 percent of soldiers and marines have some problems with PTSD, depression, or anxiety when they come home. We also now know that at about ninety days after a guy gets back from Iraq the numbers increase to at least 30 percent. Back at home, the loss of a job, family problems, and grief frequently combine to push many soldiers over the edge. I can’t imagine what it would have been like for me upon my return if I had learned that my wife had left me and/or my home was being foreclosed on.